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1
Interesting. One wonders how many blocks would be improved by the addition of dex. Cost:benefit analysis would be nice as (in my setting anyway) the cost of dex is prohibitive.
Fritsch G, Danninger T, Allerberger K et al. Dexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial. Reg Anesth Pain Med. 2014 Jan 1; 39 (1): 37-47.
  Mike Blackburn
pearl
1
Remifentanil PCIA is likely inferior to labour epidural analgesia.
Liu ZQ, Chen XB, Li HB et al. A comparison of remifentanil parturient-controlled intravenous analgesia with epidural analgesia: a meta-analysis of randomized controlled trials. Anesth. Analg. 2014 Mar 1;118(3):598-603.
  Daniel Jolley
pearl
1
Bilateral suprazygomatic maxillary nerve block significantly reduces 48 hour morphine requirements in children having cleft palate repair.
Chiono J, Raux O, Bringuier S et al. Bilateral Suprazygomatic Maxillary Nerve Block for Cleft Palate Repair in Children: A Prospective, Randomized, Double-blind Study versus Placebo. Anesthesiology. 2014 Jun 1;120(6):1362-9.
  Daniel Jolley
summary
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Remote ischaemic preconditioning was induced using a BP cuff on one arm with three 5-min-ON / 5-min-OFF cycles before surgical start. Patients receiving RIPC before elective thoracotomy and pulmonary resection experienced less acute lung injury (indicated by PaO₂/FiO₂) and a 30% shorter hospital stay compared to those who did not receive RIPC.
Li C, Xu M, Wu Y et al. Limb Remote Ischemic Preconditioning Attenuates Lung Injury after Pulmonary Resection under Propofol-Remifentanil Anesthesia: A Randomized Controlled Study. Anesthesiology. 2014 Aug 1;121(2):249-59.
  Daniel Jolley
pearl
1
Neither IV or perineural dexamethasone as part of a sciatic nerve block improved the quality of surgical recovery, but did prolong block duration.
Rahangdale R, Kendall MC, McCarthy RJ et al. The Effects of Perineural Versus Intravenous Dexamethasone on Sciatic Nerve Blockade Outcomes: A Randomized, Double-Blind, Placebo-Controlled Study. Anesth. Analg. 2014 May 1;118(5):1113-9.
  Daniel Jolley
pearl
1
Ultrasound guided placement of peripheral nerve catheters likely reduces the risk of vascular puncture and may increase successful catheter insertion.
Schnabel A, Meyer-Frießem CH, Zahn PK et al. Ultrasound compared with nerve stimulation guidance for peripheral nerve catheter placement: a meta-analysis of randomized controlled trials. Br J Anaesth. 2013 Oct 1;111(4):564-72.
  Daniel Jolley
pearl
2
Pregabalin and ketamine given together have a small, additive effect in reducing post-operative pain after total hip arthroplasty.
Martinez V, Cymerman A, Ben S et al. The analgesic efficiency of combined pregabalin and ketamine for total hip arthroplasty: a randomised, double-blind, controlled study. Anaesthesia. 2014 Jan 1;69(1):46-52.
  Daniel Jolley
pearl
1
Prophylactic administration of IV paracetamol reduces post-operative nausea and vomiting, primarily through improved post-operative analgesia.
Apfel CC, Turan A, Souza K et al. Intravenous acetaminophen reduces postoperative nausea and vomiting: a systematic review and meta-analysis. Pain. 2013 May 1; 154 (5): 677-689.
  Daniel Jolley
pearl
1
Different propofol formulations demonstrate different potencies when not mixed with lignocaine, but are similar when lignocaine is mixed.
Le M, Grassin-Delyle S, Cornet C et al. Comparison of the Potency of Different Propofol Formulations: A Randomized, Double-blind Trial Using Closed-loop Administration. Anesthesiology. 2014 Feb 1;120(2):355-64.
  Daniel Jolley
pearl
1
Fetal heart rate abnormalities occur commonly (17%) after establishing epidural or CSE labour analgesia, although without observed neonatal effects.
Patel NP, El-Wahab N, Fernando R et al. Fetal effects of combined spinal-epidural vs epidural labour analgesia: a prospective, randomised double-blind study. Anaesthesia. 2014 May 1;69(5):458-67.
  Daniel Jolley